Active NPI
Jessica Gibson
- Counselor
- Cleveland, OH
National Provider Identifier
1770010076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C.1300002
- Practice address
- 1276 W 3Rd St
Cleveland, OH 44113-1514 - Phone
- (216) 443-3762
- NPI assigned
- May 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | C.1300002 | OH | Primary |
Addresses
Primary practice location
1276 W 3Rd St
Cleveland, OH 44113-1514
Mailing address
1276 West 3Rd St
Cleveland, OH 44113
Phone (216) 443-3762
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.1300002 | OH | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494979200000",
"number": "1770010076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1276 WEST 3RD ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "44113",
"telephone_number": "216-443-3762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1276 W 3RD ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441131514",
"telephone_number": "216-443-3762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-17",
"last_updated": "2017-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "C.1300002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.